Friday, September 11, 2009

The Speech

We have our work cut out for us.

The President snapped the country back from the delusional debates of August to the more rational debate about health reform. If he has created policy space, it is an opportunity we will need to exercise until the final vote.

In rebalancing the politics of reform, he called out both elected officials and pundits who have invoked scare tactics. He also reminded us explicitly that the deficits we face today are directly attributable to Republican policies of waging an unfinanced war, and tax cuts for the super-wealthy.

We’ll know if it was effective in part if advocates for reform continue to build momentum, at town hall meetings. Will the chorus on the right become more civil? The official Republican response by Rep. Boustany was indeed a respectful disagreement. Rep. Joe Wilson of South Carolina set a different and shocking standard, accusing the President of the United States of lying about an indisputable fact.

The President made the clearest possible case for the importance of insurance reform, describing the human and financial cost of our uniquely inhumane system. The baseline proposals remain, and they would be important: eliminating pre-existing conditions and recisssions.

He offered a new benefit: A guaranteed catastrophic plan to be made available beginning in 2010.

But he proposed a public option as one of a few possible alternatives to private, for-profit insurance plans, signaling openness to a cooperative or generic nonprofit plan, and calming concerns that such a plan could lead to a single payer system. Even at best, a “robust” public option would be hard pressed to muscle out private insurance. But it must have the basics to succeed on its own terms: open to everyone as a voluntary choice right away, using the government’s power to protect the public from predatory insurance companies. As policy, that means it should start out of the gate as a nationally administered program, with the clout to intervene with drug companies and other providers. It must build on Medicare’s rates to pay providers, and use Medicare’s network of doctors and hospitals. It is time to start saying: If the private insurance industry cannot survive on terms that benefit the people who need health care, it is not the government’s role to bail them out.

It was disturbing to hear the President refer more than once to his proposals as balancing the concerns of left and right. Single payer supporters and advocates for a public plan are his base and his field team. The teabaggers and opponents of any reform are not pulling the same way. Despite his nod to Sen. McCain’s proposal for catastrophic coverage, and Republicans’ interests in medical malpractice reform, none appeared interest in voting with the President afterwards.

His discussion about our skepticism of government was important. It is understandable that many are frustrated with a government that has been unresponsive and derelict for so long. But it is a system we can influence. Mobilizing for what we want is the road to generating energetic support, and demands that our elected officials act responsibly and effectively. Resorting to demonization breeds disaffection.

The challenge is before us: to hit the air waves, the Town Hall meetings, the mail to the President and Congress to demand the change we voted for.

Also I have been debating with well meaning friends who say that the plan offered a public option. I feel that it did not, despite the President's use of that terminology.

My feeling was that it doesn't offer a public option at all because there's no "option"; only uninsurable people will be eligible, basically, and since their premiums will be its only funding, it is doomed to be insufficient for the needs of people who fit into that category.

I feel like I'm losing my mind. Everything Republicans and Blue Dogs propose - Tort Reform, Competition Across State lines, Co-ops, benefit the Insurance Industry at the expense of the people.

Obama never let single-payer on the table as a barganing chip. We should have known as soon as he appointed Nancy-Ann DeParle from the for-profit Insurance Industry. Then brought in United Health Group to negotiate. It was over before it began.

And they've won:If we kill the bill, they win. If we pass a bill without a public option, they've won. If we pass a bill with the public option as it is now, they've crippled it - no "teeth."

Only a very few people would qualify, and those that need subsidies wouldn't be allowed to choose the public option, instead we are going to subsidize them to buy one of the "for-profit" choices in the Exchange.

We will have "Romney Care" where there is plenty of competition between private insurance in the state: see Kay Lazar's article in the Globe: "Bay State health insurance premiums highest in country." They do not lower costs because that affects the profit margin for the entire industry.

So, the Insurance Industry, because of lies and mis/disinformation advocated by Republicans and Blue Dogs against their own constituents, and people who've been duped propagating those same lies, have screwed us all.

This isn't stopping me from continuing to call, write, email, fax every Blue Dog Senator and the progressive caucus' in the House.

I'm just extremely discouraged, after learning that Obama told the Blue Dogs the day after his speech, he was willing to negotiate on the public option.

Then yesterday, we learned that a United Health Lobbyist Announced a Pelosi Fundraiser As She backed off the Pubic Option.